A patient with kidney failure is prescribed a medication that is primarily excreted through the kidneys. Which of the following statements is most accurate regarding the pharmacokinetics of this medication?
Hepatic metabolism will fully compensate for the decreased renal excretion
Dose adjustment may be necessary to prevent drug accumulation
The medication's half-life will likely be shorter due to decreased renal function
The risk of drug toxicity is decreased due to impaired excretion
The Correct Answer is B
A. Hepatic metabolism will fully compensate for the decreased renal excretion: This is inaccurate. While the liver may play a role in metabolizing some drugs, it cannot fully compensate for reduced renal clearance of medications that are primarily excreted by the kidneys.
B. Dose adjustment may be necessary to prevent drug accumulation: In patients with kidney failure, reduced renal clearance slows the elimination of renally-excreted drugs. Without dose adjustment, drug levels can build up, increasing the risk of toxicity. Dosing must be tailored to the patient’s renal function, often guided by creatinine clearance or GFR.
C. The medication's half-life will likely be shorter due to decreased renal function: The opposite is true. Impaired renal function slows drug excretion, prolonging the drug’s half-life, which means the drug stays in the system longer and can accumulate to toxic levels if not adjusted.
D. The risk of drug toxicity is decreased due to impaired excretion: Impaired excretion increases, not decreases, the risk of toxicity. Renally-excreted drugs that are not properly cleared can accumulate and reach dangerous concentrations in the bloodstream.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["12.5"]
Explanation
Desired dose = 25 mg
Available concentration = 10 mg per 5 mL
- Calculate the concentration in mg/mL:
Concentration (mg/mL) = Available dose / Available volume
= 10 mg / 5 mL
= 2 mg/mL
Volume to administer = Desired dose / Available concentration
= 25 mg / 2 mg/mL
= 12.5 mL
Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"},"E":{"answers":"B"}}
Explanation
- Losartan: As an angiotensin II receptor blocker (ARB), losartan reduces aldosterone secretion, leading to decreased potassium excretion and potential hyperkalemia, especially in patients with renal impairment or those on potassium supplements.
- Furosemide: This loop diuretic promotes the excretion of sodium and potassium in the urine, commonly resulting in hypokalemia. Patients on furosemide often require potassium monitoring or supplementation.
- Spironolactone: A potassium-sparing diuretic and aldosterone antagonist, spironolactone reduces potassium excretion in the distal nephron. This can lead to hyperkalemia, particularly when used with other potassium-elevating drugs.
- Lisinopril: An ACE inhibitor that blocks the conversion of angiotensin I to II, reducing aldosterone levels and thereby decreasing potassium excretion. This places patients at risk for hyperkalemia.
- Digoxin: This cardiac glycoside may cause hypokalemia indirectly by increasing sensitivity to potassium shifts. Additionally, low potassium levels enhance digoxin toxicity, so maintaining normal potassium is critical during therapy.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.